National Healthcare Directory Attestation and Verification
1.0.0-ballot - ballot

National Healthcare Directory Attestation and Verification, published by HL7 Patient Administration Working Group. This is not an authorized publication; it is the continuous build for version 1.0.0-ballot). This version is based on the current content of https://github.com/HL7/fhir-directory-attestation/ and changes regularly. See the Directory of published versions

## : Insurance Plan Type Code System - JSON Representation

Active as of 2022-12-08

Raw json | Download

    {
      "resourceType" : "CodeSystem",
      "id" : "InsurancePlanTypeCS",
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>This code system <code>http://hl7.org/fhir/us/directory-attestation/CodeSystem/InsurancePlanTypeCS</code> defines the following codes:</p><table class=\"codes\"><tr><td style=\"white-space:nowrap\"><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td style=\"white-space:nowrap\">platinum<a name=\"InsurancePlanTypeCS-platinum\"> </a></td><td>Platinum-QHP</td><td>Plan with highest monthly premium and lowest costs when you need care\tA Qualified Health Plan with the highest monthly premiums and smallest out-of-pocket costs for the member in comparison to other metal-category plans</td></tr><tr><td style=\"white-space:nowrap\">gold<a name=\"InsurancePlanTypeCS-gold\"> </a></td><td>Gold-QHP</td><td>Plan with high monthly premium and low costs when you need care\tA Qualified Health Plan with the higher monthly premiums and smaller out-of-pocket costs for the member in comparison to other metal-category plans</td></tr><tr><td style=\"white-space:nowrap\">silver<a name=\"InsurancePlanTypeCS-silver\"> </a></td><td>Silver-QHP</td><td>Plan with moderate monthly premium and moderate costs when you need care\tA Qualified Health Plan with the lower monthly premiums and larger out-of-pocket costs for the member in comparison to other metal-category plans</td></tr><tr><td style=\"white-space:nowrap\">bronze<a name=\"InsurancePlanTypeCS-bronze\"> </a></td><td>Bronze-QHP</td><td>Plan with lowest monthly premium and highest costs when you need care\tA Qualified Health Plan with the lowest monthly premiums and largest out-of-pocket costs for the member in comparison to other metal-category plans</td></tr><tr><td style=\"white-space:nowrap\">catastrophic<a name=\"InsurancePlanTypeCS-catastrophic\"> </a></td><td>Catastrophic-QHP</td><td>A plan with low monthly premiums and very high deductibles and are available only to those under 30 or with certain special exemptions.</td></tr><tr><td style=\"white-space:nowrap\">lowdeductible<a name=\"InsurancePlanTypeCS-lowdeductible\"> </a></td><td>Low Deductible</td><td>A plan that requires the insured to pay out of pocket a smaller proportion of incurred health care costs than a traditional insurance plan.</td></tr><tr><td style=\"white-space:nowrap\">highdeductible<a name=\"InsurancePlanTypeCS-highdeductible\"> </a></td><td>High Deductible</td><td>A plan that requires the insured to pay out of pocket a larger proportion of incurred health care costs than a traditional insurance plan.</td></tr><tr><td style=\"white-space:nowrap\">catastrophicplan<a name=\"InsurancePlanTypeCS-catastrophicplan\"> </a></td><td>Catastrophic Plan</td><td>A plan that requires the insured to pay out of pocket a much larger proportion of incurred health care costs than a traditional insurance plan.</td></tr></table></div>"
      },
      "url" : "http://hl7.org/fhir/us/directory-attestation/CodeSystem/InsurancePlanTypeCS",
      "version" : "1.0.0-ballot",
      "name" : "InsurancePlanTypeCS",
      "title" : "Insurance Plan Type Code System",
      "status" : "active",
      "experimental" : false,
      "date" : "2022-12-08T23:25:31+00:00",
      "publisher" : "HL7 Patient Administration Working Group",
      "contact" : [
        {
          "name" : "HL7 Patient Administration Working Group",
          "telecom" : [
            {
              "system" : "url",
              "value" : "https://www.hl7.org/Special/committees/pafm"
            },
            {
              "system" : "email",
              "value" : "pafm@lists.HL7.org"
            }
          ]
        }
      ],
      "description" : "Categories of cost-sharing used by plans",
      "jurisdiction" : [
        {
          "coding" : [
            {
              "system" : "urn:iso:std:iso:3166",
              "code" : "US"
            }
          ]
        }
      ],
      "caseSensitive" : false,
      "content" : "complete",
      "count" : 8,
      "concept" : [
        {
          "code" : "platinum",
          "display" : "Platinum-QHP",
          "definition" : "Plan with highest monthly premium and lowest costs when you need care\tA Qualified Health Plan with the highest monthly premiums and smallest out-of-pocket costs for the member in comparison to other metal-category plans"
        },
        {
          "code" : "gold",
          "display" : "Gold-QHP",
          "definition" : "Plan with high monthly premium and low costs when you need care\tA Qualified Health Plan with the higher monthly premiums and smaller out-of-pocket costs for the member in comparison to other metal-category plans"
        },
        {
          "code" : "silver",
          "display" : "Silver-QHP",
          "definition" : "Plan with moderate monthly premium and moderate costs when you need care\tA Qualified Health Plan with the lower monthly premiums and larger out-of-pocket costs for the member in comparison to other metal-category plans"
        },
        {
          "code" : "bronze",
          "display" : "Bronze-QHP",
          "definition" : "Plan with lowest monthly premium and highest costs when you need care\tA Qualified Health Plan with the lowest monthly premiums and largest out-of-pocket costs for the member in comparison to other metal-category plans"
        },
        {
          "code" : "catastrophic",
          "display" : "Catastrophic-QHP",
          "definition" : "A plan with low monthly premiums and very high deductibles and are available only to those under 30 or with certain special exemptions."
        },
        {
          "code" : "lowdeductible",
          "display" : "Low Deductible",
          "definition" : "A plan that requires the insured to pay out of pocket a smaller proportion of incurred health care costs than a traditional insurance plan."
        },
        {
          "code" : "highdeductible",
          "display" : "High Deductible",
          "definition" : "A plan that requires the insured to pay out of pocket a larger proportion of incurred health care costs than a traditional insurance plan."
        },
        {
          "code" : "catastrophicplan",
          "display" : "Catastrophic Plan",
          "definition" : "A plan that requires the insured to pay out of pocket a much larger proportion of incurred health care costs than a traditional insurance plan."
        }
      ]
    }